“Dentists are not covered by Medicare; eyeglasses are not covered by Medicare; (nor) podiatrists. Does anybody really think we don’t need a healthy mouth to be healthy? That we don’t need healthy feet? They tell us, everybody tells us, to go out and walk. What are you going to walk on if you have a bunion pushing against the side of your foot?”

In ringing, almost prophetic terms, Barbara Ackermann thus explained why she had come to Faneuil Hall this month for the rally in favor of universal health care. She was one of some 200 elders who assembled at that historic site to advocate legislation to cover all Americans, young and old.

Ackermann, a veteran of municipal and state political involvement, feels deeply about this issue. She cannot understand how our national government can leave more than 40 million Americans uncovered.

In the statement quoted above, she was refuting the commonly held view that people over 65 already have universal health care coverage. Admitting that her own financial situation gives her special access, she and her husband spend some $17,000 each year on health care not covered by Medicare.

“You don’t have to add to the worries about health care how you’re going to pay for it,” she tells fellow advocates. “It (coverage) seems normal to me, and it seems outrageous that we don’t have it.”

The driving force behind this rally was the Massachusetts Senior Action Council, a group of elders who are actively concerned with health care and other issues that affect the well-being of our society. I asked Ralph Hergert, the dynamic new director of the association, how he could put so much energy into a cause that, at the moment, seems hopelessly lost.

Chuckling, my old friend responded: “I believe in impossible ideals, that we need to work on them every day.” Like the other leaders present, he knows what the odds are, but he feels determined to push ahead for something of such vital importance to the community he serves.

Among those other leaders were two congressmen, John Tierney from Massachusetts’ North Shore area and Maurice Hinchey who represents a New York district near the Hudson Valley and the Catskill Mountains.

Tierney thinks that a grassroots effort is needed and calls for working from idealism. “This country was built on idealism,” he said. But he also offered a pragmatic reason: “The cost to businesses, forcing them to be uncompetitive with others, it’s all coming to a head.”

Hinchey also struck this same note: “For Americans to be healthy and strong, we need a system of national health insurance now. It’s important for our economy, we are at a disadvantage – General Motors spends more on health insurance than on steel.”

Longtime advocate Sterling Alam, now retired from AARP, was among those in the audience. In asking him questions, I discovered how he combines a certain skepticism with hope. “I think the single payer is something we are going to do eventually, when things get bad enough,” he told me.

Union organizer Rand Wilson outlines the three basic elements of any comprehensive health plan. Access, quality, and cost are the issues that it must address. Does everyone have the right to treatment? Is this health care excellent across the board? How much do people have to pay for coverage?

Another viewpoint on health care came from April Taylor, who works with African American residents in Roxbury, Dorchester, and Mattapan. She sees the need for not mere coverage but what see calls “culturally competent health care.” In her experience, some service providers have a poor understanding  of culture, class, race and gender.

Ms. Taylor points to national statistics that suggest black people have their limbs amputated more often than do other people. Instead of getting life-saving drugs, too frequently they suffer this drastic surgical intervention.

These advocates have two specific goals in mind. The first is proposed legislation in Congress. HR 676 currently has some 50 sponsors, Congressman Hinchey among them. But even he admits that “in the current environment it has absolutely no chance.” He believes, though, that we can and must change that environment.

The other initiative is a Massachusetts constitutional amendment for health care. This citizens’ initiative needs over 70 thousand signatures before qualifying for a constitutional convention. Sponsored by an agency called Mass-Care, it would ensure that every resident of the commonwealth would have access to affordable health care.

One speaker revealed that the number of uninsured in this state is at an all-time high, and the problem continues to grow worse. There is pressing reason to move forward on both fronts, national and state.

AARP would seem to be a strong ally. In “Reimagining America,” a newly published agenda for change, it states that “the U.S. health care system needs to be transformed to ensure access to more affordable, higher quality care.” This change AARP calls “America’s highest priority.”

Those wishing to get involved can call the Massachusetts Senior Action Council at (617) 442-3330.

Richard Griffin